New position starts in January

Dr. Joshua M. Sharfstein said Wednesday he plans to leave his post as secretary of the state Department of Health and Mental Hygiene, where he drew criticism for the botched rollout of the state's health insurance exchange website.

Sharfstein, a trained pediatrician who has spent his career in public service, will join the Johns Hopkins Bloomberg School of Public Health as an associate dean in January as the O'Malley administration ends.

He took the state post three years ago after developing a national profile for his aggressive pursuit of public health initiatives in children's health, HIV and other areas.

As health secretary in Maryland, he revamped the way hospitals treat and charge patients and the way abortion clinics and tanning salons are regulated. He's worked to reduce a backlog of cases at the board of physicians and pushed for a ban on potentially deadly crib bumpers.

But he also oversaw the state's health insurance exchange, which crashed on the first day and caused problems for thousands trying to buy health insurance. The persistent troubles with the system prompted the state to cut ties with the original contractor and ultimately decide to replace the exchange altogether with new technology.

Sharfstein and the health department also came under scrutiny this month after a medically fragile 10-year-old boy died in a Laurel-area facility overseen by one of its agencies. While the Office of Health Care Quality had been inspecting the LifeLine facility, it acknowledged it didn't know about some financial and care issues there. The office also acknowledged that it had not inspected many of the other 14,000 health facilities under its purview on schedule.

Sharfstein, 44, will not begin his new position as associate dean for public health practice and training until after the relaunch of the health exchange website in the fall.

He told his staff in a letter Wednesday that the technological problems would not make his highlight reel.

"I do remember, however, the moment when Gov. Martin O'Malley pulled me aside and told me that what mattered most was rising to the challenge," wrote Sharfstein, who was paid $169,404 in the fiscal year ended June 30.

One longtime critic of the exchange was quick to lay blame for the exchange troubles on Sharfstein and said it was past time for him to go.

"We were pleased to see that Joshua Sharfstein, secretary of the Department of Health and Mental Hygiene, has finally agreed to resign, especially after the national debacle that he and Anthony Brown were responsible for with the rollout of the Maryland Health Benefit Exchange," said Republican gubernatorial candidate Larry Hogan, referring to the lieutenant governor who also was the state point man for the federal health reform.

"But his resignation should be immediate," he added.

Brown, the Democratic nominee for governor, did not respond to a request for comment.

Others from Annapolis to Baltimore praised the secretary and pointed more to his response than the initial failure — and to the nearly 375,000 people who eventually signed up for health insurance.

Sharfstein was known for his hands-on leadership, long hours and attention to detail — character traits that were necessary to steer the state's largest department, and handle the exchange crisis, said JohnM. Colmers, his predecessor as health secretary and now a John Hopkins Medicine vice president

Judging Sharfstein solely on the exchange was unfair, Colmers said, considering the vast responsibilities and complexities of the job managing the $10 billion health department budget and overseeing Medicaid and programs in behavioral and public health, as well as those for the disabled.

"It's big and necessarily big," he said of the department. "On a daily basis, things can happen of which you have little control. And being able to achieve the things he was able to achieve is certainly to be commended. It will all have a lasting impact."

Another observer agreed that Sharfstein likely would be recalled for his full body of work, and the announcement of his departure was timely.

"I expect we'll be seeing this from nearly all department heads in next few weeks and few months," said Donald F. Norris, a University of Maryland Baltimore County professor of public policy. "I don't know that any of them will necessarily be retained."

Before Sharfstein starts at Hopkins in January, he plans to work not only on the exchange but on issues such as drug overdoses, patient safety and behavioral health.

His next position, he said, will keep him engaged in policy and government issues, and Dr. Michael J. Klag, dean of the Hopkins Bloomberg School, lauded his experience. Sharfstein will succeed Thomas Burke, who is President Barack Obama's nominee to lead the Environmental Protection Agency's Office of Research and Development.